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DISCUSSION: Dr. Melvin Stanger disagreed with much that Dr. Isay said, but welcomed the provocative paper as a stimulus to clarify many concepts regarding homosexuality. First, he disagreed with Dr. Isay's concept of neutrality, which involves accepting homosexuality as a given. He felt it rested on false premises: that homosexual orientation cannot be changed through psychoanalysis; and that homosexuality may be adaptive if interfering conflicts are resolved. True neutrality, said Dr. Stanger, included a professional ethical wish to help a patient achieve all he was capable of, while remaining flexible enough to settle for limitations in goals if that proved necessary. It did not foreclose the possibility of change, as did Dr. Isay's view of neutrality. He also wondered if Dr. Isay's use of transference exploitation to effect sexual behavioral change did not in itself make sexual orientation change impossible. Dr. Stanger commented on the difficulties in treating the overt homosexual as opposed to the "defensive" homosexual. While acknowledging phallic oedipal determinants, he stressed the preoedipal origins of the homosexual's conflicts which make it difficult for him to tolerate his intense loneliness and anxiety. The

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